Individual
MS. TERESA ANN DICKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3816 SHADOW RIDGE DRIVE, NORMAN, OK 73072
(405) 573-9905
Mailing address
2527 W ORBIT DR, GUTHRIE, OK 73044-6311
(405) 694-1933
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200129170A
—
OK
Enumeration date
10/12/2012
Last updated
10/12/2012
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